Factors Associated With Integrated Care for Older People in Health Facilities in the City of Kindu, Maniema Province, Democratic Republic of the Congo

Background: Population ageing is a major public health challenge, particularly in settings where health systems have limited human, material, and financial resources. In the Democratic Republic of the Congo (DRC), integrated care for older people continues to face challenges related to healthcare providers’ competencies, professional practices, resource availability, service organization, and care coordination. Objective: To analyse the factors associated with integrated care for older people in health facilities in the city of Kindu, Maniema Province, with a view to proposing an improvement model adapted to the local context. Methods: A mixed-methods approach combining quantitative and qualitative methods was used to examine healthcare providers’ knowledge, competencies, attitudes, and practices, as well as health promotion strategies, palliative care, resource availability, and service organization. The analysis also covered care procedures, referral mechanisms, supervision, and interprofessional coordination among 423 healthcare providers, using survey and interview techniques. Results: The findings revealed several organizational and operational shortcomings. The absence of pain management protocols was reported by 54.8% of respondents, while 46.3% reported the absence of formalized referral mechanisms for palliative care. Furthermore, 73.5% identified insufficient staffing or a lack of available healthcare personnel as an obstacle to continuity and quality of care. These findings led to the proposal of the RACINE de TUKALUP model (2026), structured around six pillars: the State, insurance schemes and mutual health organizations, residential care facilities, healthcare institutions, universities, and older people. The model advocates a person-centred approach integrating prevention, health promotion, curative care, rehabilitation, psychosocial support, and palliative care. It also emphasizes governance, financial protection, continuing professional development, resource availability, and coordination of interventions.